Adolescents who are involved in bullying—victims and perpetrators alike—are more likely to say they would want to undergo cosmetic surgery to be more attractive or fix perceived flaws, reports a study in the May issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Among bullying victims, increased desire for cosmetic surgery is related to poor psychological functioning, according to the new research by Dieter Wolke, PhD, and colleagues of University of Warwick, Coventry, United Kingdom. "Our results suggest that cosmetic surgeons should screen candidates for psychological vulnerability and history of bullying," Dr. Wolke comments.

Bullies and Victims Both Have Increased Desire for Cosmetic Surgery

The study explored the relationship between bullying and interest in cosmetic surgery in British students aged 11 to 16. In the first phase of the study, nearly 2,800 teens were screened for involvement in bullying, as rated by themselves and their peers.

The second phase focused on 752 adolescents, including 139 identified as victims of bullying, 146 as perpetrators of bullying, and 294 who were both victims and perpetrators. The remaining 173 teens were uninvolved in bullying. Participants were asked whether they would like to have cosmetic surgery as a way of making themselves more attractive or changing something about their appearance.

The results showed that adolescents involved in bullying in any role were more interested in cosmetic surgery, compared to those uninvolved in bullying. Desire for cosmetic surgery was highest in bullying victims, but was also increased in bullying perpetrators.

Interest in cosmetic surgery was higher in girls than boys, as well as in older teens and in those whose parents had a lower level of education. But teens involved in bullying, including both boys and girls, had more desire for cosmetic surgery than their uninvolved peers.

"Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery," Dr. Wolke and coauthors write. In contrast, for perpetrators of bullying, the desire for cosmetic surgery was unrelated to psychological functioning. The researchers add, "For bullies, cosmetic surgery may simply be another tactic to increase social status...to look good and achieve dominance."

As rates of cosmetic surgery increase, researchers are interested in understanding the factors that lead people to desire a change in their appearance. Previous studies have found that around half of adults seeking cosmetic surgery report a history of teasing or bullying.

The new study suggests that the relationship between bullying and cosmetic surgery is already present in adolescents who are currently being victimized by their peers. "The desire for cosmetic surgery in bullied adolescents is thus immediate and long-lasting," Dr. Wolke and coauthors write.

The link to poor psychological functioning is consistent with previous studies identifying poor body image as a key driver of desire for cosmetic surgery. The researchers suggest that plastic surgeons should consider screening for psychological vulnerability and past history of bullying victimization when evaluating patients for cosmetic surgery—in adults as well as adolescents. Dr. Wolke and colleagues add, "Addressing the mental health of bullied adolescents may reduce their desire for cosmetic surgery."